After a bicycle accident (fall), the 15 year-old student developed a partial paralysis of both legs.

Pathomorphology or Pathophysiology of this disease :

Traumatic divulsion of the hind edge of the 7th thoracic vertebra, which caused the compression of the myelon. This is shown in the ossic divulsion as deflected.

Next to the multisegmental alteration of the spinal structures (see below), the fracture to the 7th thoracic vertebra is labelled instable due to the involvement of the hind edge.

Radiological findings:

CT 1: MPR - Sagittal

CT 2: Transversal

MRI 1: Sagittal

MRI 2: Sagittal

MRI 3: Transversal

Due to the pressure of the hind edge of the 7th thoracic vertebra, there is an obvious compression of the myelon in the level of the base plate ventrally (slightly paramedianally). In the T2-weighted image, there is a hyperintese depiction of the myelon in the region of the compression as a representation of a beginning myelon edema.

Edema of the marrow of the 5th, 6th, 7th and 8th thoracic vertebrae as a representation of the trauma. Pathologic ventral height decrease of the 8th thoracic vertebra (compression fracture).

Obvious edematously change of the paravertebral soft tissue (with some proof of blood) in the level of the thoracic vertebra 4-9, laterally as well as dorsally (dorsal to the spinous process).

Diagnosis confirmation:

Total constellation (Consens)

Which DD would be also possible with the radiological findings:

N/A

Course / Prognosis / Frequency / Other :

The remission of the neurologic deficits are dependent on the primary alteration of the myelon and the time frame until the decompression surgery.